Is TSH useful for Wechseljahre?

TSH (thyroid-stimulating hormone) is a standard test for thyroid function. During menopause, symptoms such as fatigue, weight changes, mood swings, and hot flashes can overlap with thyroid disorders. Measuring TSH helps rule out hypothyroidism or hyperthyroidism, which are common in perimenopausal women. However, TSH is not a direct marker of menopause—it does not measure estradiol levels or ovarian reserve. The evidence for TSH utility in menopause comes from clinical practice guidelines (e.g., American Thyroid Association) and observational studies, not from randomized controlled trials specifically evaluating TSH in menopause management. Therefore, while TSH is useful for differential diagnosis, it should not be used alone to guide menopause treatment. Comprehensive hormone testing (estradiol, FSH, AMH) is needed for menopause assessment. TSH is only informative if thyroid symptoms are present. Evidence grade: practice (clinical standard).